Note: This post is rather detailed but I’m neither a doctor nor a vet. I’m sharing these details in hope that other dog owners might detect the signs earlier. Please always seek your vet’s advice and don’t take my sharing as a medical advice. Sometimes, it’s a tough road if you’re going through the same thing, hopefully this post gives you strength.
Buffy was developing some kind of growth in her front right elbow since late 2010 (roughly in the month on August). We always thought it was due to her constant pressure on those spots. She also had a similar growth on her front right elbow. They normally start looking like a dark layer of soft excess skin.
We never thought much of it. Until March 2011, we noticed the growth on her front right elbow was getting larger and her carpal on the same leg was looking swollen.
She would sometimes limp a little.
In the early years...
On 17th April, 2011, we took her in for a second check. A radiography (x-ray) was taken on the carpal area and fine needle aspiration (FNA) was performed on her elbow. The vet attending to her was Dr. Ben from Segar Veterinary Hospital.
The diagnosis and prognosis:
Right (F) Elbow: No strange cells were detected. Nothing was detected through the test
Diagnosis: Hygroma, due to constant knocking and hitting on hard surfaces. Hyper dogs are prone to that.
Right (F) Carpal: X-ray showed her carpal area has some bone deterioration.
Diagnosis: Bone infection due to bacterial infection. He did prematurely mention bone cancer but said it’s too early.
Prescription: Rimadyl 75mg (pain killer) for 1 tab, 2 times x 10days and Clindamycin 15mg (antibiotic for bacterial infection) 2tabs, 2 times x 10days.
Vet’s advice: Try to bolster her elbow with socks/elbow guard and keep her favourite spot well-cushioned.
Result: In 1week, her hygroma and the swelling reduced in size.
But in April, her hygroma came back. She was limping again. We took her into UPM Veterinary on 21st of April, 2011 and she was prescribed to same medications as above with an additional one: Metronidazole 400mg 2tabs, 2times x 6days, also a kind of antibiotic that works well with Clindamycin. The vet attending to her was Dr. Grace from UPM Veterinary Hospital.
Her condition didn’t worsen nor improve; I took her in to UPM for an assessment on27th April, 2011. X-ray was taken and her elbow and carpal condition remained the same.
Since her condition didn’t worsen, we assumed the medication is helping stabilize her so she was prescribed to another 2weeks on similar antibiotics.
Occasionally her growth on the elbow would get harder and sometimes ulcerated. We kept it bandaged to prevent infection. As a result of the bandage, her carpal would swell up more due restriction of blood flow.
We tried carpeting her floor, elbow guards, changing her bandages frequently but nothing helped much. We took her for another opinion and that vet, suggested to try a different antibiotic – Doxycline. That too didn’t show remarkable results, only keeping her pain at bay.
Too much antibiotic is also known to be harmful for her internal organs; hence we gave it a break. We noticed, without antibiotics she was in more pain and moved less.
On 11TH May, 2011, I took her to UPM again. This time a new vet was attending to Buffy and we took x-ray of her carpal and elbow area. No new diagnosis except to continue her medication.
On June 8th, 2011, I took her into UPM again. This time chest radiography was done because the vet in charge – Dr Sylvia suspected an unusual breathing pattern. Her x-ray revealed she had a heart condition. A scotch tape test and blood test was done.
The diagnosis and prognosis:
Right (F) Elbow: Scotch tape test didn’t show any harmful cells
Diagnosis: No new development
Right (F) Carpal: X-ray showed her some bone deterioration in the carpal area. No improvement or worsening.
Diagnosis: Bone infection called Osteomyelitis and possibility of Osteosarcoma (bone cancer)
Heart: X-ray was done
Diagnosis: Heart beat irregular
Prescription: Multico, Fortekor 10mg for 2weeks and Clindamycin 15mg (antibiotic for bacterial infection) 2 1/2tabs, 2 times x 14days.
Vet’s advice: Try to bolster her elbow with socks/elbow guard and keep her favourite spot well-cushioned.
Result: Occasional improvement in her physical ability but seemed dependant on antibiotics.
I took her in on 24th June, 2011, Dr Sylvia ruled out Osteosarcoma and that gave me great relief. But Osteomyelitis was still in the picture. Same medications were prescribed to her.
Despite all the test, medications and constant irritation of her right limb, Buffy never showed any lack of excitement for life. We were asked to keep her activities to a minimal due to her heart condition.
She had great appetite and enjoyed going for walks. She’d limp on some days, but never stopped her from begging us for a walk. Besides that, she never failed to throw a mean bark at suspicious passerby.
Her eyes glowed and her desire for her normal way of life was very evident.
Again on 24th October, 2011, I took her to UPM in hope for new remedy for poor Buffy. Dr. Munira didn’t give me any new diagnosis after looking at the x-ray. Her carpal didn’t look too different from her past x-rays.
By this point, I was beginning to wonder if the vets in UPM went through her past medical history before sending her off with the same diagnosis. Or if they have ran out of ideas to detect what is causing this growth. Her growth in her elbow has ulcerated and gotten infected with pus. We just couldn’t get it to close up.
Our floor would be smeared with blood stains and smell of infection filled our living area. That didn’t deter us from keeping her indoors because it gave her so much joy staying close to us. We hoped for improvements and it seemed far-fetched on some days.
Watching her lay helplessly would sadden me a great deal. On some days, she showed no signs of pain. We saw how hard she fought to be normal and we never treated her any different because of her condition.
Somewhere during the month of November, I took Buffy in to see a new vet that was recommended by a friend. St. Angel Medical Animal Centre in Puchong. We met Dr Ding. He said the open wound in her elbow could have caused the infection to her carpal and didn’t rule out Osteosarcoma. He also suggested making an appointment to meet Dr Gayathri from UPM, who apparently is the cancer specialist there.
On 30th December, 2011, I took her into UPM again. A new vet was attending to her, Dr Ong. She conducted some x-rays and brought up Osteosarcoma again. There goes that word!. She suggested I meet up with Dr Gayathri, to my suprise, it was the same Dr. Suggested by Dr. Ding. What a coincidence.
I saw that as a good sign.
We went back in to see Dr Gaya on the 5th January, 2012. She was very detailed in her procedures and gave me very clear understanding of Buffy’s situation.
Based on Buffy’s medical history with UPM, she had 2 possible diagnosis: Fungal infection or tumor.
She suspected it to be more of a fungal bone infection instead of a bacterial bone infection, hence none of the antibiotics worked well (because they were for bacterial infections). She still called it Osteomyelitis.
Her second possible diagnosis was tumor. She didn’t think of this as the possible cause of her condition. That gave me comfort.
When she finally had one look at Buffy’s elbow which is ulcerated at this point, she immediately said, ‘it’s tumor’ My heart sank. I couldn’t believe what I’ve just heard.
She took impression smears, blood test and radiographs of her front leg.
The diagnosis and prognosis:
Right (F) Elbow: Impression smears - Cytology
Diagnosis: Malignant Tumor (quite an aggressive one, actively dividing)
Right (F) Carpal: X-ray showed that the metacarpals/digits (knuckles) have bone deterioration as well. In the past it was only the carpal area. It has worsened.
Diagnosis: Bone infection called Osteomyelitis due to fungal and bacteria
Blood sample Result: Red blood cell was good, Kidney good, Liver normal, cogulation parameters good. White cells build up due to infection.
Prescription: Multico, Clavamox, Metronidazole, Piroxicam
Vet’s recommendation:
Amputation of her front right leg was her best vote. Local removal of the mass is possible but might have suture breakdown, causing long term healing repercussion. She might have to go in for several surgeries to fix the wound if it keeps opening up. Not recommended as Buffy is a heart patient.
Plus, there is a possibility of the tumor cells flaring up due to the removal of the local mass.
Amputation came with its own set of challenges too. She could lose a lot of blood.
Lastly, there is still a possibility of the tumor cells spreading to lungs, liver and spleen.
It wasn’t an easy decision to make. If we didn’t take any action, the tumor cells would spread to her body. Her wound would get larger and more ulcerated.
If we did opt for amputation, there’s a risk she could die on the surgery table because she’s a heart patient. She could also lose a lot of blood and there’s no guarantee the tumor cells could spread to her organs.
Either way, it was a tough decision.
We took 1 week to deliberate over it. I also took her to see Dr Ding of St. Angel Animal centre again for his take. He too was prone towards the amputation. Giving us assurance that Buffy would be able to live well for few more years if the surgery were successful.
After much consideration and weighing, we sent Buffy in on the 16th of January, 2012 for amputation. She had the best specialist attending to her at UPM. The orthopaedic operating her was one of the best in the country, Dr Loqman of UPM, Veterinary.
I felt more certain that Buffy was going to make it out alright.
For some unforeseen circumstances, Buffy’s operation was pushed to the next day. She had to go through some test and Dr Loqman was also on another duty. He was still keen to operate Buffy and pushed the operation to the next day.
I went to visit Buffy on the 16th noon, to see how she was doing. She was in her ward and seemed rather quiet but was very happy to see me.
I sat with her and assured her it was going to be alright. I gave some treats and left our t-shirts as comfort reminders.
The next day, when Buffy got sedated, the doctor in charge, Dr Siti, called to update me on her status. Half way through surgery around 12.30noon, she called me again assuring that she’s stable but it’s not over yet.
She also told me that Dr Loqman decided to amputate from her scapula as its best. To promote faster healing and to be sure no tumor cells are left in her right limb.
The surgery took 4 hours. I got a call around 4-ish that Buffy is out of surgery and is stable. I was so damn relieved.
I went over to see her at 5.15pm. I had some problems trying to get visiting rights. That’s another story altogether – read post title: ‘pathetic precious 5 minutes’
When I got in, I saw her lying with a huge bandage over her chest. She was lying on her side that just got amputated. I couldn’t see the effect of it because it was bandaged. Nonetheless, it wasn’t easy to see your dog with 1 less leg.
Her eyes were open, she looked stable. I touched her belly and spoke to her. She was reacting to my voice. She made some movements. I was so glad to see her alive. She even tried to get up twice. Dr. Gaya who walked in not long after, advised me to not excite her too much as she needs to rest.
I was so certain she’d make it out. I didn’t say goodbye to her as I was so confident i’d see her the next day and the day after. I was planning the visiting times with Dr Gaya up to the end of the week before I left.
I left the hospital knowing she’d going to be home soon. She’s always been a fighter. I left the hospital around 6.30pm to visit my friend Che, who is visiting from Slovakia.
At 7ish, my phone rang and it was the UPM vet’s no. my heart skipped a little faster. It was Dr Sylvia on the phone. I could hear was she was saying but it didn’t make sense to me. She repeated it twice, “Shuba I have a bad news to tell you, after you left, Buffy had breathing problems and she passed away.”
It was surreal to hear her say that because I just saw her, trying to get up to greet me. How can something so strong willed be dead?
It didn’t sound right. I stopped by the side of the road on the way to Mid Valley, and tried to make sense of it but all I could do was fight back tears.
I couldn’t breathe nor think straight. I called my husband, told him the news and his reply was, ‘fucking hell.’ He told me to stay where I am and he’d come get me.
He called Dr Sylvia and organised the next steps.
We went over to UPM at 9pm to pick up her up. Some say, seeing is believing, but my eyes couldn’t believe what I saw.
The same buffy I saw at 6.30pm for the last time was alive and now she’s lifeless and blue.
My beautiful Buffy is gone.
I am reminded again, how unpredictable life is.
We drove her home in our car and it seemed so morbid. We put her on the floor and took time to say our goodbyes. Janice was also here to see her.
All three of us, buried her that same night. I guess, Buffy wanted all 3 of us to send her off.
She had a great life.
She gave it her all.
She never held back.
She continues to live in our hearts.
